Lumbar Radiofrequency Ablation

What is lumbar radiofrequency ablation?

 

Lumbar radiofrequency ablation is a minimally invasive procedure that reduces pain by interrupting the small medial branch nerves supplying the lumbar facet joints.

​

Facet joints are small joints at the back of the spine that help guide movement and provide stability. They can become painful because of arthritis, injury or age-related changes.

​

Radiofrequency ablation uses carefully controlled heat to interrupt pain signals from these nerves without affecting the strength or movement of your back.

​

The procedure is performed under X-ray guidance to ensure accurate placement of the treatment needles.

​

What are facet joints?

 

Each vertebra in the lower back is connected by a pair of facet joints. These joints allow the spine to bend and twist while providing stability.

​

When the facet joints become inflamed or arthritic they can produce:

• Pain across the lower back

• Pain into the buttocks

• Pain when standing or walking

• Pain when leaning backwards

• Stiffness after resting

​

Facet joint pain rarely causes pain below the knee or significant numbness and weakness.

​

Who may benefit?

 

Lumbar radiofrequency ablation may be appropriate if you have:

• Persistent low back pain lasting more than three months

• Pain thought to arise from the lumbar facet joints

• Pain that has not improved with physiotherapy and medication

• Significant but temporary relief from diagnostic medial branch blocks

• Pain affecting work, sleep or everyday activities

​

The procedure is not suitable for every type of back pain and is unlikely to help pain arising from discs, muscles or nerve root compression.

​

How do we determine whether I'm suitable?

 

A careful assessment is the most important step.

​

This usually includes:

• A detailed discussion of your symptoms

• Physical examination

• Review of previous scans

• Consideration of other possible causes of pain

• Diagnostic medial branch nerve blocks

​

Diagnostic nerve blocks temporarily numb the medial branch nerves. If these provide significant short-term pain relief, radiofrequency ablation may be recommended as a longer-lasting treatment.

​

What happens during the procedure?

 

Lumbar radiofrequency ablation is usually performed as a day-case procedure under local anaesthetic.

The procedure typically takes 30 to 45 minutes.

​

It involves:

1. Positioning you comfortably on the X-ray table.

2. Cleaning the skin and applying local anaesthetic.

3. Using X-ray guidance to position specialised needles beside the medial branch nerves.

4. Performing sensory and motor stimulation to confirm accurate needle placement.

5. Applying controlled radiofrequency energy to each target nerve.

6. Removing the needles and applying small dressings.

​

Most patients return home shortly afterwards.

​

Recovery

 

It is common to experience temporary soreness around the treatment sites for several days.

​

Most patients can:

• Walk immediately after the procedure

• Return to light activities within one or two days

• Resume normal activities gradually over the following weeks

​

Pain relief is usually not immediate. Improvement often develops over two to six weeks as the treated nerves stop transmitting pain signals.

​

Continuing your exercise programme and physiotherapy is strongly recommended to maximise the benefits of treatment.

​

What are the benefits?

 

For carefully selected patients, lumbar radiofrequency ablation may:

• Reduce persistent low back pain

• Improve walking and standing tolerance

• Improve sleep

• Increase participation in exercise and rehabilitation

• Improve quality of life

• Reduce reliance on pain medication

​

Relief varies between individuals and cannot be guaranteed.

​

What are the risks?

 

Lumbar radiofrequency ablation is generally considered a safe procedure, although all interventions carry some risk.

​

Possible complications include:

• Temporary soreness

• Bruising

• Bleeding

• Infection

• Temporary increase in pain

• Temporary numbness around the treatment area

• Failure to improve symptoms

• Very rarely, injury to nearby nerves or blood vessels

• ​

These risks will be discussed fully during your consultation before proceeding with treatment.

​

Frequently Asked Questions

 

Will radiofrequency ablation cure my back pain?

 

No.

Radiofrequency ablation aims to reduce pain arising from the facet joints but does not reverse arthritis or cure the underlying condition.

​

How long does pain relief last?

 

Many patients experience pain relief for several months. As the treated nerves gradually regenerate, symptoms may return and repeat treatment may be considered if appropriate.

​

Will I be asleep?

 

The procedure is usually performed under local anaesthetic. Sedation is not routinely required but may occasionally be considered.

​

Can I have the treatment more than once?

 

Yes.

If you previously experienced good pain relief and your symptoms return, repeat treatment may be appropriate.

​

Is radiofrequency better than facet joint injections?

 

Facet joint injections and radiofrequency ablation have different roles.

Diagnostic injections help identify whether the facet joints are causing your pain, while radiofrequency ablation aims to provide longer-lasting pain relief in suitable patients.

​

Will I still need physiotherapy?

 

Yes.

The best outcomes are usually achieved by combining pain relief with ongoing exercise and rehabilitation.

​

Why choose Dr David Crabtree?

 

As a Consultant in Pain Medicine, I specialise in the assessment and treatment of persistent spinal pain.

 

Careful diagnosis is essential before recommending any intervention.

​

Where lumbar radiofrequency ablation is appropriate, procedures are performed under X-ray guidance using evidence-based techniques to maximise accuracy, safety and the likelihood of a successful outcome.

​

Ready to explore your treatment options?

 

If persistent low back pain is affecting your quality of life despite physiotherapy, medication or previous injections, a consultation can help determine whether lumbar radiofrequency ablation or another treatment is the most appropriate option for you.